| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON DELAWARE INC | PO BOX 28852 LOCKBOX 28852 NEW YORK, NY 100878852 | METROPOLITAN LIFE INSURANCE COMPANY | — | $24K | $24K | 1.74% |
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON PENNSYLVANIA INC. | PO BOX 8500 PHILADELPHIA, PA 191788500 | METROPOLITAN LIFE INSURANCE COMPANY | — | $2K | $2K | 0.15% |
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON DELAWARE, INC. | COMMISSION LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 100878852 | HYATT LEGAL PLANS, INC. | $3K | — | $3K | 10.21% |
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON DELAWARE INC. | LOCKBOX 741909 PO BOX 741090 ATLANTA, GA 303741909 | HYATT LEGAL PLANS, INC. | — | $517 | $517 | 1.69% |
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON PENNSYLVANIA, INC | LOCKBOX 9102 PO BOX 8500 PHILDELPHIA, PA 191789102 | HYATT LEGAL PLANS, INC. | — | $74 | $74 | 0.24% |
No Schedule C service providers reported on this filing.
Benefits declared on the Form 5500 main form (✓ = also has a Schedule A insurance contract; otherwise the benefit is funded out of plan assets or via a Schedule C TPA).
The plan reports several different headcounts depending on which form you read. Each one measures a different slice of the population.
| Active participants | 1,323 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 9 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 124 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,456 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 2,742 | $1.4M |
| Vision | VISION SERVICE PLAN | 2,369 | $444K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 2,742 | $1.4M |
| Short-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 2,742 | $1.4M |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 2,742 | $1.4M |
| Stop-loss / reinsurancereinsurance | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE CO. | 4,880 | $162K |
| Other(3 contracts, 3 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 2,742 | $1.5M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 4,880 | — |
Why the numbers differ. Form 5500 line 6 counts employees + retirees + beneficiaries; no dependents. Schedule A persons-covered counts everyone enrolled, including spouses and children, so it usually exceeds line 6 by 30-60% on a working-age workforce. The medical row is normally the broadest single line because it has the highest take-up; dental/vision/life often dip below it. Stop-loss / reinsurance contracts sometimes report the carrier's full underwriting pool rather than this filer's headcount; the row is shown for transparency but shouldn't be read as "people in this plan."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.